Thread by @Suburbanbella

So this is the response from Envision's CEO to the hubbub that occurred a couple of weeks ago regarding their dismissal of anesthesiologists from WRMC in Wisconsin. It reads as one would expect..I'll leave it at that. He states that "physicians" were not replaced by CRNAs. No one

2)claimed that--I will be more specific and reiterate ANESTHESIOLOGISTS were terminated from WRMC and replaced. And they were not replaced by air. How do I know? Look at the original letter that states they are going to a "100% CRNA model". If they were using CRNAs in this model

3)before, then why was it necessary to make the announcement in the first place? In addition, a lead CRNA will be managing anesthesia services. Not an anesthesiologist. Also note in the letter the statement, "An Envision anesthesiologist will be on staff at this hospital and will

4) work closely with CRNAs." Translation: "On staff" ≠ "on-site", but someone will be around. "...work closely with CRNAs" = accessible by phone. And who will that anesthesiologist be? Most likely the regional director of anesthesia services mentioned in the original letter and

5)who resides in another state. The CEO minimizes and is dismissive of the topics around SOP as well as nomenclature(corporate medicine loves "providers"). These are serious issues; patients have a right to know who is caring for them and be confident that person is practicing

6)within his/her SOP. The CEO denies PE had any play in the decision at WRMC. I'm no investor, but common sense dictates that no one invests in PE unless they expect to make a profit. Period. Medicine is a business, pure and simple. PE could careless about quality of care, they

7)are not HCPs, they represent businesspeople who have to keep their investors happy. If cutting expensive resources increases revenue, you better believe it will be done. And anesthesiologists are expensive resources. They get paid for their expertise, that's how it works. The

8)CEO also speaks warmly of all members of the team and being so proud that Envision is part of that team. Then I read part of a presentation on Envision's advice on leveraging the talent pool on the team. "Employ the least expensive cost to accomplish the mission." Nothing in

9)this statement indicates they value the expertise of emergency physicians, FM/IM docs or NPPs. FM/IM and NPPs are simply cost-saving measures, that's it. Senior residents are an asset to moving the meat and saving money since they get paid s**t. The poor interns are considered

10)a burden. Doesn't this make you feel all warm and fuzzy inside? Envision is not the only private-equity backed CMG that exists with this mindset. There are plenty others. IMO, business has no place in medicine because patients will never be number one. Ever. Investors will

11)always hold that position. Physicians, RNs, NPPs, hospital staff, etc.,all widgets in this corporate medicine machine.That obvious COI is unacceptable in my book.
"Your people are not your greatest asset. They're not yours, and they're not assets."--Rodd Wagner. #peoplematter

12)****Correction: The letter is written by the president of Envision, not the CEO.****